Unit 1 – Public HealthWhat is Public Health?
Chapter 1 – Public Health: Science, Politics, and Prevention
What is Public Health?The fulfillment of society’s interest in
assuring the conditions in which people can be healthy.
Organized community efforts aimed at the prevention of disease and the promotion of health.
Core Functions of Public HealthAssessmentPolicy DevelopmentAssurance
Public Health vs. Medical CareIn medicine the patient is the individual; in
public health, the patient is the communityPublic health diagnoses the health of the
community using public health sciencesTreatment of the community involves new
policies and interventionsGoal of medicine is cure; goal of public health
is prevention of disease and disability
Public Health: Science and PoliticsScience is how we understand threats to
health, determine what interventions might work, and evaluate whether the interventions worked
Politics is how we as a society make decisions about what policies to implement
Public Health DisciplinesEpidemiologyStatisticsBiomedical SciencesEnvironmental Health ScienceSocial and Behavioral SciencesHealth Policy and Management
EpidemiologyThe basic science of public healthThe study of epidemicsAims to control spread of infectious diseasesSeeks causes of chronic disease and ways to
limit harmful exposures.
StatisticsCollection of data on the populationThese numbers are diagnostic tools for the
health of the communityThe science of statistics is used to calculate
Biomedical SciencesInfectious diseases – pathogens Chronic diseasesGenetics
Environmental Health ScienceHealth effects of environmental exposuresAir QualityWater QualitySolid and hazardous wastesSafe food and drugsGlobal environmental change
Social and Behavioral SciencesBehavior is now the leading factor in
affecting people’s healthTheories of health behavior: social
environment affects people’s behaviorMajor health threats: tobacco, poor diet and
physical inactivity, injuriesMaternal and child health – a social issue
Health Policy and ManagementRole of medical care in public healthCost of medical care in U.S. is out of controlU.S. has a high percentage of population
without health insurance – these people often lack access to medical care
Quality of medical care can be measured, and is often questionable.
Public Health: Prevention and InterventionPrimary prevention Secondary preventionTertiary prevention
Public Health ApproachDefine the health problemIdentify the risk factors associated with
the problemDevelop and test community-level
interventions to control or prevent the cause of the problem
Implement interventions to improve the health of the population.
Monitor the interventions to assess their effectiveness.
Chain of CausationAgentHostEnvironmentInterventions can focus on any of these
Public Health and TerrorismEvents of 9/11 and the anthrax letters
highlighted the importance of public health.
The public health response to disasters, both natural and man-made, helps to control the damage and prevent further harm to survivors and rescuers.
Bioterrorism is recognized primarily through classical public health measures similar to those used in natural epidemics.
Unit 1 – Public HealthWhat is Public Health?
Chapter 3 – Powers and Responsibilities of Government
Federal vs. State U.S. Constitution: To promote the general
welfareReserve clause: since health is not
mentioned in the Constitution, primary responsibility belongs to the states
Interstate commerce clause justifies federal role in some cases
Power to tax and spend is widely used by federal government to control public health policy
Branches of Government (federal, state, local)Legislative – passes statutesExecutive – public health agencies carry out
the law; may issue regulations consistent with statutes
Judicial – laws and regulations can be challenged in court
Local Public Health AgenciesCounty and city health departmentsDay-to-day responsibilityCore public health functionsOften also have responsibility for
providing medical care for the poorFunding sources are variable; city or
county legislatures may not understand importance of core functions.
Mandates may be funded from state or federal governments.
State Health DepartmentsCoordinate activities of local health
agencies and provide fundingCollect and analyze dataLaboratory servicesManage MedicaidLicense and certify medical personnel,
facilities, and servicesEnvironment, mental health, social
services, and aging may be handled by separate agencies
Federal AgenciesDepartment of Health and Human
Services (HHS)(www.hhs.gov)Centers for Disease Control and Prevention
(CDC) (www.cdc.gov)National Institutes of Health (NIH)
(www.nih.gov)Food and Drug Administration (FDA)
(www.fda.gov)Centers for Medicare & Medicaid Services
(CMS) (www.cms.gov)Agency for Healthcare Research and Quality
Federal Agencies (ctd.) Environmental Protection Agency (EPA)
(www.epa.gov)Occupational Safety and Health
Administration (OSHA) (www.osha.gov)Department of Agriculture (USDA)
(www.usda.gov)National Highway Traffic Safety
Administration (NHTSA) (www.nhtsa.gov)
Centers for Disease Control and PreventionMain epidemiologic and assessment
agency for the nationPublishes Morbidity and Mortality Weekly
Report (MMWR)Center for Health Statistics – collects data
on U.S. population concerning all aspects of health
Centers on infectious diseases, chronic disease, injury prevention, and others
National Institutes of HealthBiomedical research agencyInstitutes on cancer, heart and lung
disease, diabetes, aging, child health and human development, and others.
National Library of MedicineHas laboratories in Bethesda, MD and
provides grant funding to researchers in universities and research centers.
Clinical Center where medical researchers test experimental therapies
Nongovernmental Public Health OrganizationsAmerican Cancer Society, American Heart
Association, American Diabetes Association, Alzheimer’s Disease and Related Disorders Association, and others
American Medical Association, American Nurses Association, American Public Health Association, and others
Philanthropic FoundationsRockefeller FoundationRobert Wood Johnson FoundationPew Charitable TrustsKaiser Family FoundationCommonwealth FundBill and Melinda Gates Foundation